Health insurance in Andorra, whether or not you pay into the CASS

Is there something unusual about your case? Tell us in the questionnaire

The first question: do you contribute to the CASS?

Everything else follows from this. If you work in Andorra, employed or self-employed, you are registered with the CASS and your contributions buy your public cover. An employee pays in 22 % of salary in total: 6.5 % comes out of the payslip and 15.5 % is paid by the employer. A private policy, in that case, only adds what the CASS leaves out.

If you live here without working, you are not in the CASS just because you moved. Passive residents and digital nomads have to show the Govern a health policy for themselves and their dependants, and that policy will pay for almost all their medical care.

How the CASS refund works

The CASS never pays the whole bill. It sets a reference price for each medical act, the tarifa de responsabilitat, and refunds a percentage of that price. The percentage depends on what was done and on whether you came through your referring doctor.

These rates apply to practitioners and centres with a CASS agreement. With a practitioner outside the agreement, the refund is calculated on 20 % of the tariff, so very little comes back. Each rate is explained in the CASS explained.

Your referring doctor

The via preferent starts with a GP you choose, your metge referent. If you need a specialist, the referral comes from that doctor and lasts 18 months, up to 12 visits. Emergencies treated at the medical centres on the ski slopes, and emergencies abroad, count as if you had followed the route.

The first weeks after registering

Registration does not open refunds the next morning. The first time, the CASS asks for 25 days of contributions before it pays for ordinary illness or an accident outside work. Until you reach 12 months, it also asks for 15 days of contributions in the month before the visit. If you arrive on a new contract, plan for those first weeks: you pay, or a short private policy does.

What the CASS never pays

• The rest of each act: a quarter of a consultation and a tenth of a hospital stay, even through the referring doctor.
• Anything a practitioner charges above the CASS tariff.
• Any cost for someone who is not affiliated, such as a passive resident or a visitor.
• A mountain rescue that the Govern decides to bill. See ski insurance and mountain rescue.

Three products sold as "health insurance"

If you contribute, read private health insurance and the CASS top-up. If you are moving without work, start with the passive residency health policy.

Partner and children

Your CASS registration can cover your family without them contributing. A spouse or registered partner and children can be listed as indirect insured persons, children up to and including age 24. After that they need their own affiliation or private cover. Before paying for a family top-up, ask the CASS who is listed as your dependant so you don't insure anyone twice.

What to check in the contract

• Whether it refunds on the CASS tariff or on what you actually paid.
• Which hospitals outside Andorra it includes: Catalonia, the rest of Spain, France.
• Whether skiing and mountain sports are covered or excluded as risk activities.
• Waiting periods for each benefit.
• Whether the insurer is authorised in Andorra: check the list of licensed insurers.

Andorran insurers don't publish their health tariffs, so we don't give an average price. If you describe your situation in the contact form, we will point you to the right guide.

Real cases on the blog: Family on CASS, CASS waiting periods, CASS travel forms and Pregnancy after moving.